Objective: Non-invasive positive pressure ventilation (NPPV) is a relatively new modality of managing acute respiratory failure (ARF). It has not been applied before in our area. The aim of this study is to verify the use of NPPV on patients with ARF at a general hospital level.
Methods: All patients admitted at the Al-Amiri Hospital, Kuwait (a secondary medical center) between 1999 and 2001 with ARF and met the inclusion criteria were included in the study. The non-invasive mode of nasal ventilation was used as the respiratory support.
Results: A total of 21 patients were included in the final analysis. The major cause of ARF type 2 was chronic obstructive pulmonary disease (COPD) in 71%. The overall success rate of NPPV trials was 71.4%. In the successful trials of ARF type 2, the arterial blood gas parameters of PaCo2 (p<0.005), pH (p=0.023), and PaO2 (p<0.001) showed improvement from the first hour of intervention. Analysis of variance with repeated measurement for the arterial blood gas variables showed statistical significance of changes in favor of NPPV during initial close monitoring with p<0.001. The percentage of successful trials at the general wards was 82% versus 67% for the intensive care unit cases (ICU). Surprisingly, failure of trials related mainly to the clinical status of the patients.
Conclusion: Non-invasive positive pressure ventilation is an effective ventilatory support in ARF in a proper clinical setting. It may be used safely in the general hospital outside the ICU.